Columbia Memorial Hospital

National Labor Relations Board - Administrative Judge Opinions

Aug 26, 2011

03-CA-027921 (N.L.R.B. Aug. 26, 2011)

JD–50–11
Hudson, NY
UNITED STATES OF AMERICA
BEFORE THE NATIONAL LABOR RELATIONS BOARD
DIVISION OF JUDGES
COLUMBIA MEMORIAL HOSPITAL
and Cases 3-CA-27921
3-CA-27967
1199 SEIU, UNITED HEALTHCARE
WORKERS EAST
Alfred M. Norek, Esq.,
for the General Counsel.
Richard P. Walsh, Jr., Esq.,
and Paul E. Davenport, Esq.,
(Lombardi, Walsh, Wakeman
Harrison, Amodeo & Davenport, P.C.)
of Albany, New York, for the Respondent.
Vanessa Flores, Esq., and David
Slutsky, Esq., (Levy Ratner, P.C.)
of New York, New York,
for the Charging Party.
DECISION
STATEMENT OF THE CASE
PAUL BOGAS, Administrative Law Judge. This case was tried in Albany, New York, on
May 24 and May 25, 2011. The initial charge was filed by 1199 SEIU, United Healthcare
Workers East (the Union) on December 28, 2010. The Union filed a second charge on February
15, 2011, and amended that charge on March 25, 2011. The General Counsel issued the
consolidated complaint (the complaint) on March 29, 2011. The complaint alleges that
Columbia Memorial Hospital (the Respondent) violated Section 8(a)(1) by, inter alia, prohibiting
its employees from wearing certain union paraphernalia, and violated Section 8(a)(3) and (1) by
suspending an employee for wearing prohibited union paraphernalia. The Respondent filed a
timely answer in which it denied committing any of the violations alleged.
On the entire record, including my observation of the demeanor of the witnesses, and
after considering the briefs filed by the General Counsel, the Respondent and the Union, I make
the following findings of fact and conclusions of law.
JD–50–11
2
FINDINGS OF FACT5
I. JURISDICTION
The Respondent, a corporation, provides medical services, including but not limited to
acute care, at its hospital facility in Hudson, New York, where it derives gross revenues in excess 10
of $250,000 and receives goods valued in excess of $5000 directly from points outside the State
of New York. The Respondent admits, and I find, that it is an employer engaged in commerce
within the meaning of Section 2(2), (6), and (7) of the Act and a health care institution within the
meaning of Section 2(14) of the Act. The Union is a labor organization within the meaning of
Section 2(5) of the Act.15
II. Alleged Unfair Labor Practices
A. Background Facts
20
The Respondent operates a hospital that provides a range of medical services to the
public. Two groups of employees at the hospital are represented by the Union. One is a
bargaining unit of approximately 250 professional employees and the other is unit of between
300 and 400 service and technical employees. A single labor contract covers both bargaining
units. In July 2010, the Union and the Respondent executed a collective bargaining agreement 25
that was set to expire 5 months later on December 31, 2010. In August 2010, the parties began
negotiations for a successor to that agreement. Those negotiations were ongoing during the
period that the complaint covers. The parties reached a memorandum of agreement for a new
contract on May 12, 2011.
30
B. Respondent’s Dress Code/Professional Image Policy
The Respondent contends that it lawfully prohibited employees from wearing certain
union buttons and stickers in patient-care areas pursuant to the hospital’s policy on "Dress 35
Code/Professional Image." The version of this policy in effect since August 2008 provides in
relevant part:
POLICY:
Employees of Columbia Memorial Hospital (CMH) must display a professional image to 40
reflect the value CMH places on its patients, residents and visitors. Our purpose is to
convey a professional appearance to patients, visitors, and coworkers.
* * *
RESPONSIBILITIES:45
All employees will adhere to dress code standards as directed by their Director, Manager
or Supervisor. All supervisors are responsible for ensuring their staff maintains
appropriate standards in appearance. Employees must dress appropriately for work.
Columbia Memorial Hospital reserves the right to determine what dress is appropriate.
50
* * *
JD–50–11
3
5
COMPLIANCE
. . . If an employee's appearance does not conform to hospital standards, they must
correct it before they can begin work. If they must go home to do this they will not be
paid until they return to work. A second incident will start disciplinary Action . . . .
10
* * *
Questions about items not covered in the policy, and exemptions and changes, MUST be
referred to the Vice President of Human Resources BEFORE taking action.
15
Respondent’s Exhibit Number (R Exh.) 1. The Respondent takes into account the nature of the
department where the employee works when deciding what is acceptable attire. For example,
employees are required to wear socks or pantyhose in patient care areas in order to guard against
infections, but are not required to wear them in the business office. Among the items that the
Respondent has customarily prohibited under the policy are jeans, sleeveless sundresses, 20
sweatshirts with logos, hooded sweatshirts or sweaters, visible piercings, and visible tattoos.
Pursuant to the policy, Employees have been asked to remove articles of clothing, cover tattoos,
and remove or cover visible piercings.
Since well before the alleged violations, and continuing during the period of negotiations 25
for a successor contract, the Respondent has allowed employees to wear a variety of buttons,
pins and other accessories in both patient-care areas and non-patient-care areas of the hospital.
The items that the Respondent routinely permits employees to wear in all areas of the hospital
include several expressing support for the Union. For example, the Respondent permits
employees to wear lanyards that have "1199 SEIU United Healthcare Workers East," printed on 30
them. The Respondent also permits employees to wear a rectangular pin that is approximately 2
½ inches by ½ inch, bears the Union's logo, and reads "1199 SEIU New York's Health & Human
Service Union."1 In addition to this union-related paraphernalia, the Respondent has permitted
employees to wear items indicating, inter alia, their years of service, educational alma mater,
certifications, firefighting work, Knights of Columbus affiliation, and various personal interests 35
(e.g., Winnie-the-Pooh and Santa Claus). All of the non-union-related accessories that were
entered as exhibits were rather small or unobtrusive.
The Respondent states that, under the professional image policy, it permits employees to
wear buttons/stickers with messages that are "mere statements of affiliation" in all areas of the 40

1 During contract negotiations at least one employee placed a rather large, pro-union, card behind his
hospital identification card in the clear plastic holder that he wore on a lanyard for the purposes of
displaying the identification card. The pro-union card is approximately three and one-half inches by three
inches, and reads: “Fair Contract NOW! We Deserve It!” The card also bears the Union’s name and
logo. This card faced the employee’s chest and was hidden from view except when the identification card
holder spun around so that the identification card faced the employee’s chest and the “fair contract” card
faced out. I find that the record evidence does not establish that the “fair contract” card was generally
visible or that the Respondent knew about, or knowingly permitted, it to be displayed. Two management
officials, Barb Naccarato and Karen Altomer, credibly testified that they had never observed any
employee wearing the “fair contract” card in a patient-care area prior to taking the actions alleged to be
unlawful in this case.
JD–50–11
4
hospital, but prohibits employees from displaying buttons/stickers that carry "inflammatory or 5
controversial" messages while those employees are in patient-care areas. Brief of Respondent at
Page 2. It was not shown that this interpretation of the professional image policy existed in
written form, but the interpretation is consistent with the testimony of the Respondent’s officials
regarding the reasons for the decisions to prohibit employees from wearing certain union
paraphernalia in patient-care areas. Moreover, the record did not show that the officials who 10
took the challenged actions in this case had ever knowingly permitted an employee in a patient-
care area to display any accessory – whether related to the Union or not – that could reasonably
be described as controversial or inflammatory.
C. Naccarato Reacts to Stomp Sticker; Macagnone Suspended; Policy Issued15
On December 22, 2010, the Union distributed a new sticker to employees. The sticker
shows the small figure of a man, approximately one inch tall, who is raising his hands to protect
against a giant boot that is about to stomp on him. The sole of the boot is about twice as long as
the man is tall. The entire sticker is about two and half inches in diameter, has a bright yellow 20
background, and a small union logo at the bottom.2 This "stomp" sticker was created to express
the Union’s view that, in the ongoing contract negotiations, the hospital wanted to "step on" the
employees.
On December 22, Barbara Naccarato, the Respondent’s director of emergency services, 25
observed two employees in the emergency department wearing the stomp sticker. Naccarato
concluded that the sticker violated the Respondent’s professional image dress policy. She
testified that approximately 80 percent of the Respondent’s patients are admitted through the
emergency department and that it is important to provide an environment there that encourages
patients to trust the hospital to care for them. Naccarato approached the two employees – Terry 30
Roule3 and Betsy Mathrick – who she saw with the stomp sticker and told them: "You shouldn’t
be wearing that. It doesn't belong here. It's a patient care area."4 The employees responded that
their understanding was that Ray Jones, the Respondent’s vice president of human resources, had
approved the wearing of the sticker. That day, Naccarato attempted unsuccessfully to reach
Jones to ask him if this was true and, in the meantime, she permitted the employees to continue 35
displaying the stomp sticker.
The next day, December 23, Naccarato reached Jones by phone. She told him about the
stomp sticker, and stated that in her view wearing that sticker in a patient-care area was a
violation of the professional image policy. Jones agreed with her and stated that he had not 40
approved the wearing of the sticker. Shortly after her conversation with Jones, Naccarato met
individually with three employees who were wearing the stomp sticker in the emergency
department that day – Joseph Macagnone, Julie Propst, and Roule.

2 The sticker was entered as an exhibit at trial and a photocopy of it is included with this decision as
Appendix B.
3 The briefs filed by the parties spell this name alternatively as Roule and Rowley. The record does
not reveal what the correct spelling is. The transcript uses “Roule,” but notes that the court reporter
arrived at this phonetically.
4 The record shows that Roule wore scrubs at work. It does not show what Mathrick wore.
JD–50–11
5
Macagnone is a mental health assistant in the emergency department whose job it is to 5
help new mental health patients acclimate to the hospital. His duties include getting the patients
into hospital clothes, obtaining blood samples, urine samples and vital signs, and, if necessary,
restraining the patients and keeping them, in Macagnone’s words, "nice and quiet."5 At work he
wears scrubs that he supplies himself. When Naccarato met with Macagnone about the stomp
sticker there was also another hospital manager present – Marie Carrabello, education 10
coordinator. At the meeting, Naccarato asked Macagnone to remove the stomp sticker. She told
him that "it's not professional, it doesn't meet our policy, and it's not appropriate in a patient-care
area." She explained that she considered "the sticker to be very controversial and that our
patients should not . . . be put in the position to maybe feel uncomfortable." Macagnone refused
to remove the sticker. Naccarato informed Macagnone that if he refused to remove the sticker 15
she would "consider that being insubordinate" and "would have no recourse but to follow the
disciplinary process." Macagnone still refused to remove the sticker. Macagnone pointed out to
Naccarato that he had been wearing a union lanyard and various buttons and pins since the first
day of his employment, and that the Respondent's officials had not previously said anything to
him about it. Naccarato did not respond to this comment. She told Macagnone that she was 20
suspending him pending an investigation and that she would need an opportunity to prepare the
disciplinary paperwork. Macagnone left the office.
Macagnone came to Naccarato's office shortly thereafter, this time accompanied by
Cindy Northrup, a union delegate and negotiator. Naccarato again asked Macagnone to remove 25
the stomp sticker and Macagnone once again stated that he would not do so. At that point
Naccarato handed Macagnone disciplinary paperwork stating that he was suspended pending an
investigation for refusing her instruction to remove the sticker. Macagnone asked how many
days he was being suspended for and Naccarato answered that the suspension was of "indefinite"
duration. During this meeting, Northrup pointed out that she too was wearing the stomp sticker. 30
Naccarato testified that Northrup was in a non-patient-care area and, therefore, was not violating
any policy by wearing the sticker.
Also on December 23, Naccarato met with Roule and Julie Propst – two employees who,
like Macagnone, were wearing the stomp sticker in the emergency department. Naccarato told 35
Roule that the sticker was inappropriate in a patient care area and asked her to remove it. Roule
initially refused, but after Naccarato asked her a second time, Roule took the sticker off. Roule
was not disciplined in any way. Subsequently, Naccarato called Propst into her office, and said
"I asked you to come in here because you’re wearing a sticker that I think is unprofessional,
inappropriate and controversial, it doesn’t belong in our patient-care area, and I’m going to 40
request that you remove it." Propst agreed to remove the sticker and no disciplinary action was
taken against her. The events of the day caused some emergency department employees to
discuss whether they would be disciplined if they wore the stomp sticker. At some point on
December 23, a number of union officials who were not hospital employees came to Naccarato’s

5 The prior September 2010, Macagnone became a union delegate “in training,” but he did not
become an elected union delegate until January 2011. He was also one of the ten members of the Union
bargaining committee and helped distribute the stomp sticker to other union members. Although it is fair
to infer that that the Respondent was aware of Macagnone’s participation on the bargaining committee,
the record does not show or support an inference that, in December 2010, the Respondent was aware of
Macagnone’s status as a delegate in training or of his involvement in the distribution of stickers.
JD–50–11
6
office to confront her about the actions she was taking with respect to Macagnone’s display of5
the stomp sticker. These individuals caused a commotion in Naccarato’s office and in a hallway
close to a patient-care area.
The Respondent concedes that it received no formal complaints from patients or visitors
regarding any of the union paraphernalia at-issue in this proceeding. However, the Respondent 10
does contend that an informal complaint was made about the stomp sticker. The Respondent
relies on the testimony of Naccarato, who stated that Carrabello (the same manager who attended
the December 23 disciplinary meeting with Macagnone) told her that Carrabello's own father had
been a patient in the hospital and had stated to Carrabello that the stomp sticker "doesn’t belong
here." I do not credit this report. It is hearsay in that neither Carrabello nor her father testified. 15
The report was, moreover, not corroborated in any way. Although the Respondent generally
documents and investigates patient and visitor complaints, it did not document or make any
investigation regarding what Carrabello is claimed to have reported to Naccarato. Moreover, I
find it suspicious that the individual who allegedly communicated this comment to Naccarato
was the same manager who Naccarato had trusted to serve as her witness during the disciplinary 20
meeting with Macagnone. Lastly, I note that the language that Naccarato ascribes to
Carrabello’s father – i.e., the sticker "doesn’t belong" here – is the same formulation that
Naccarato herself used in talking to Roule and Mathrick on December 22 and to Propst on
December 23. This leads me to suspect that Naccarato's own reaction to the sticker influenced
her recollection of anything that Carrabello reported to her. 25
On December 23, 2010, the Respondent issued a memorandum to its directors prohibiting
employees from wearing the stomp sticker in patient-care areas. That memorandum stated:
It has been brought to our attention, that employees have been seen wearing a 30
yellow sticker with a large foot appearing to be stepping on a person.
Please be advised that this insignia is not to be worn in any patient care area.
Please advise your employees that at any time they are in patient care areas, the
insignia must be removed. 35
Thank you in advance for your attention to this matter.
General Counsel’s Exhibit Number (GC Exh.) 2.
40
As discussed above, Northrup wore the stomp sticker when she came to Naccarato's
office. She also wore it in the hospital pharmacy where she worked. The pharmacy is not a
patient-care area and during the time period from late 2010 to early 2011 Northrup's work as a
pharmacist rarely brought her to patient-care areas of the hospital.6 In January 2011, Northrup’s
supervisor advised her that other supervisors might ask Northrup to remove the stomp sticker 45
when she visited patient-care areas of the hospital; however, Northrup has never actually been
asked to remove the sticker.

6 Beginning in April 2011, regulatory changes caused Northrup to begin visiting patient-care areas
more frequently.
JD–50–11
7
D. Macagnone’s Suspension Ends; He Begins Wearing "Proud 1199" Button 5
On December 29, Naccarato contacted Macagnone by phone to tell him that his
suspension was for 5 days and that he could return to work, but would not be permitted to wear
the stomp sticker. Macagnone returned to work on January 1, 2011. He did not wear the stomp
sticker after his return, but did attach a new pro-union button to his lanyard. The new button 10
reads "PROUD 1199 SEIU Member." The button is approximately 3 inches in diameter, and the
words are in yellow against a purple and red background.7 Naccarato first noticed that
Macagnone was wearing the proud 1199 button on January 18. She had observed other
employees wearing the button, but Macagnone was the first employee she saw wearing it in a
patient-care area. In her view, wearing this button in a patient-care area violated the 15
Respondent’s professional image policy.
On January 18, Naccarato called Macagnone to her office. Naccarato asked Macagnone
to remove the proud 1199 button. Macagnone initially refused, but then the union representative
who was accompanying Macagnone advised him to remove the button to avoid being suspended 20
again. Macagnone agreed to remove the button, but told Naccarato that he was doing so "under
duress." At trial, Naccarato explained that she asked Macagnone to remove this button because
it was “political” in nature and therefore inappropriate in a patient care area. She testified that
the button was political by virtue of its size, which she characterized as "a little exorbitant."
25
E. "Access Denied" Button
Karen Altomer is the nursing coordinator for the Respondent's medical/surgical,
orthopedic, pediatric, ventilator, hemodialysis, and hospice operations. On December 24, 2010,
Altomer was covering duties in addition to her own – acting as a supervisor for the entire 30
hospital. She entered the intensive care unit, which was not one of her usual areas of
responsibility. Altomer observed that Marquerite Coates, the secretary for the intensive care
unit,8 was at her work station wearing a button with this message:
ACCESS35
DENIED!
Ask the Boss
WHY?
The button is approximately three inches in diameter and the message is written in large white 40
letters against a blue background.9 The Union created this button to protest the Respondent’s
refusal to allow union representatives to enter satellite clinics operated by the hospital.
Altomer concluded that Coates’ display of the button violated the Respondent’s
professional image policy. She noted that Coates' work duties included interacting with patients 45

7 A photocopy of the button was introduced as an exhibit at trial and is included with this decision as
Appendix C.
8 Coates is not required to wear a uniform at work.
9 A photocopy of the button was introduced as an exhibit at trial and is included with this decision as
Appendix D.
JD–50–11
8
and visitors in the intensive care unit. At trial, Altomer testified that the button violated policy 5
because "it's loud, it’s inflammatory, it's coarse, it changes the focus of patient care." In
addition, she testified that she was concerned that the button could be interpreted by patients to
mean that they were being denied access to care or services. Altomer stated that the hospital
works to maintain "a tranquil caring environment" and that display of the access denied button
"contradicts that." She had not, she testified, previously seen the access denied button, the proud 10
1199 button, or the stomp sticker, on any employee who she supervised in a patient care area.10
Altomer was aware that employees in areas she supervised wore union lanyards, but she stated
that she permitted that because "it’s just a logo."
Before taking action with respect to Coates' display of the access denied button, Altomer 15
contacted Jones (vice president for human resources) and described the button to him.
Afterwards, Altomer told Coates that she was asking her to remove the button because Coates
was working in a patient-care area. Coates questioned why she was being asked to do this, and
Altomer responded that wearing the button in a patient-care area violated hospital policy. Coates
asked to see the relevant policy, but Altomer did not provide anything. Coates refused to remove 20
the button, and Altomer told Coates that she was receiving a "verbal corrective action" for this
refusal. Then Altomer asked again that Coates remove the button. Coates refused. Altomer told
Coates that she would be suspended pending an investigation if she did not remove the button.
At that point Coates removed the button. After Coates removed the button, Altomer did not
discipline her in any way. 25
F. "Have a Heart" Sticker
On February 14, 2011, the Union distributed a sticker that read "HAVE A HEART DO
YOUR PART," in large letters and identified the Union in smaller letters. The sticker was 30
created for Valentines Day to encourage members to be active in the Union. The sticker is
approximately 2 ½ inches in diameter and the writing is in black against a yellow heart with a
white background.11 Coates placed the sticker on her shoulder. On February 16, Coates was
wearing the heart sticker and was approached about it by her supervisor – Sarah Freiss, director
of patient care services. Freiss told Coates: "You can’t wear that . . . sticker in patient areas. 35
Would you take it off." Coates removed the sticker from her person. She placed the sticker on a
vase that was on her desk. Freiss made no comment to Coates about placing the sticker on the
vase, and Coates was not disciplined in any way.
The Respondent does not claim that it received any complaints from patients or visitors 40
regarding the heart sticker, and Coates testified that she received no comments about it from
patients or visitors. At trial, the Respondent did not call Freiss or any other official involved in
the decision to instruct Coates to remove the heart sticker.

10 Similarly, Naccarato testified that prior to December 22, 2010, she had not seen the access denied
button, the proud 1199 button, or the stomp sticker on any employee who she supervised in a patient care
area.
11 The sticker was introduced as an exhibit at trial and a photocopy of it is included with this decision
as Appendix E.
JD–50–11
9
G. Complaint Allegations5
The complaint alleges that the Respondent violated Section 8(a)(1) of the Act: on
December 23, 2010, when Naccarato threatened employees with discipline for wearing stickers
in support of the Union, and promulgated and maintained a rule prohibiting employees from
wearing Union insignia; on January 18, 2011, when Naccarato threatened an employee with 10
discipline for wearing Union insignia; on December 24, 2010, when Altomer threatened an
employee with discipline for wearing a pro-Union button; and, on February 16, 2011, when
Freiss enforced a rule prohibiting employees from wearing a pro-Union sticker. The complaint
further alleges that, on December 23, 2010, Naccarato suspended Macagnone for wearing a pro-
Union button, and did so because of Macagnone's union and concerted activities, and that the 15
Respondent thereby violated Section 8(a)(3) and (1) of the Act.
III. Analysis and Discussion
A. Section 8(a)(1) Allegations20
It is well established that healthcare facilities are not subject to some of the Board
policies regarding dress codes as those policies are applied in industrial settings, "but rather are
subject to other policies which recognize[] the need to balance the interest and comfort of the
patients against the Section 7 rights of employees." Medical Center of Beaver County, Inc. 266 25
NLRB 429, 430 (1983); see also NLRB v. Baptist Hosp., Inc., 442 U.S. 773, 779 (1979)
("Congress has committed to the Board the task of striking the appropriate balance among the
interests of hospital employees, patients, and employers."). Thus while employees' display of
union insignias or apparel is a right protected under Section 7 of the Act, Republic Aviation
Corp. v. NLRB, 324 U.S. 793, 801-803 (1945), the Board has held that "[i]n healthcare facilities, 30
restrictions on the wearing of union-related buttons are presumptively valid in immediate patient
care areas." Sacred Heart Medical Center, 347 NLRB 531 (2006), review granted on other
grounds sub nom. Washington State Nurse’s Ass’n v. NLRB, 526 F.3d 577 (9th Cir. 2008). The
Supreme Court has reasoned that it is appropriate to grant hospitals special latitude to restrict
union activity in patient-care areas since hospitals "'are not factories or mines or assembly 35
plants'" but rather facilities "'where patients and relatives alike often are under emotional strain
and worry, where pleasing and comforting patients are principal facets of the day's activity, and
where the patient and his family – irrespective of whether that patient and that family are labor or
management oriented – need a restful, uncluttered, relaxing, and helpful atmosphere, rather than
one remindful of the tensions of the marketplace in addition to the tensions of the sick bed.'" 40
NLRB v. Baptist Hospital, Inc., 442 U.S. at 783 n.12, quoting the concurring opinion of Justice
Blackmun in Beth Israel Hospital v. NLRB, 437 U.S. 483, 509 (1978). The Board has held,
however, that the presumption of validity only extends to restrictions in patient-care areas.
Restrictions that also limit the display of union buttons in non-patient-care areas are
presumptively invalid, and such restrictions are permissible only if the healthcare facility 45
establishes "'special circumstances,'" i.e., that the restriction is "necessary to avoid disruption of
health care operations or disturbance of patients." Id. at 779, quoting Beth Israel Hospital v.
NLRB, 437 U.S. at 507.
Given the distinction between the treatment of restrictions in patient-care areas and non-50
patient-care areas, the first order of business in analyzing the allegation that the Respondent
JD–50–11
10
violated the Act by prohibiting hospital employees from wearing certain union paraphernalia is 5
to determine whether the Respondent was restricting their display only in patient-care areas, or
whether it was also restricting their display in non-patient-care areas. I find that the Respondent
restricted the wearing of union buttons and stickers exclusively in patient-care areas. In each of
the instances alleged in the complaint the restriction was enforced to prohibit an employee from
wearing the button or sticker while in a patient care area. All of the employees who Naccarato 10
told to remove either the stomp sticker or the proud 1199 button in December 2010 and January
2011 (Macagnone, Roule, Mathrick, and Propst) were working in the emergency department – a
patient-care area – at the time. When Altomer told Coates to remove the access denied button in
December 2010, Coates was working in the intensive care unit – another patient-care area.
Lastly, when Freiss told Coates to remove the "have a heart" button in February 2011, she 15
specified that Coates could not wear the button in a patient area. The record is devoid of
evidence that any employee was ever told that he or she could not wear a union button or sticker
while working in a non-patient-care area or that the Respondent made any general
pronouncements to the workforce that might have been understood by employees to prohibit
them from wearing any union button or sticker while in non-patient-care areas. To the contrary, 20
Northrup, the General Counsel’s own witness, testified that she had been consistently wearing
the boot sticker at her work station, which was a non-patient-care area, and had never been asked
to remove it.
A finding that the restriction only applied in patient-care areas is also supported by the 25
Respondent’s December 23 memorandum regarding the stomp sticker. That memorandum
specifies that the sticker "is not to be worn in any patient care area" and that "any time
[employees] are in patient care areas, the insignia must be removed." The memorandum does
not state a hospital-wide prohibition, nor does it state, or in any way suggest, that the button
cannot be worn in non-patient-care areas. Similarly, the evidence shows that, when30
communicating the restriction to employees working in patient-care areas, the Respondent’s
officials generally specified that the restriction applied in patient-care areas and never implied
that the restriction extended beyond those areas. For example, when Naccarato directed
employees working in the emergency department to remove the stomp sticker, she noted to each
that the sticker was not appropriate in a patient-care area. When Altomer approached Coates on 35
December 24 about the access denied button, she told her to remove it in patient-care areas.
When Freiss approached Coates on February 14 about the heart sticker she told Coates not to
wear it in "patient areas." Moreover, the Respondent was not shown to have confiscated the
buttons or stickers, or otherwise to have interfered with the employees' ability to easily resume
displaying the item after exiting the patient-care area. Cf. Mt. Clemens General Hospital, 33540
NLRB 48, 50 (2001) (hospital's prohibition on union button unlawful where, inter alia, the
hospital confiscated the button), enfd. 328 F.3d 837 (6th Cir. 2003); cf. Enloe Medical Center,
345 NLRB 874, 876 (2005) (ban extending to both patient-care and non-patient-care areas
unlawful because, inter alia, hospital could have allowed employees to "remove and later put
back on their [union] badges when moving in and out of patient care areas"), affd. after remand, 45
348 NLRB 991 (2006).
For the reasons discussed above, I conclude that the Respondent restricted the wearing of
the union stickers and buttons at-issue here exclusively in patient-care areas, and therefore that
those restrictions were all presumptively valid. The next question is what must the General 50
Counsel show in order to rebut the presumption that the restrictions were valid. The briefs filed
JD–50–11
11
in this case reveal that the parties are essentially in agreement that the General Counsel may 5
overcome the presumption of validity by showing that the restrictions have been enforced
discriminatorily/disparately or without a legitimate basis. Brief of General Counsel at Page 11;
Brief of Respondent at Page 3; Brief of Charging Party at Page 1. Although the precedent cited
by the parties in support of this rebuttal standard is somewhat thin,12 I adopt that standard since it
is reasonable and not contrary to any other precedent identified by the parties or my own review 10
of the case law. I apply the rebuttal standard with an eye towards the Supreme Court's
admonition that hospitals require special latitude to restrict union activity in patient-care areas
because those are settings "'where patients and relatives alike often are under emotional strain
and worry, where pleasing and comforting patients are principal facets of the day’s activity, and
where the patient and his family . . . need a restful, uncluttered, relaxing, and helpful 15
atmosphere.'" NLRB v. Baptist Hospital, Inc., 442 U.S. at 783 n.12. I turn now to consideration
of whether the General Counsel has succeeded in rebutting the presumption of validity that
attaches to the restrictions that the Respondent applied in this case.
Stomp Sticker: Regarding the stomp sticker, I conclude that the General Counsel has failed 20
to meet the burden of showing that the Respondent’s prohibition of that sticker was
discriminatory or without a legitimate basis. The sticker, which shows a small man about to be
crushed by a giant boot, is more than the type of display of affiliation that the Respondent has
traditionally permitted irrespective of union content. Rather I find that the sticker is facially

12 The parties cite The Register-Guard, 351 NLRB 1110 (2007), enfd. in part 571 F.3d 53 (D.C.
2009), Mt. Clemens General Hospital, supra, and London Memorial Hospital, 238 NLRB 704, 709-710
(1978). The decision in The Register-Guard involves a newspaper, not a hospital, and thus does not
invoke the patient-care area presumption of validity at all. In London Memorial Hospital the restriction
at-issue was not limited to patient-care areas and thus was presumptively invalid, not presumptively valid,
under Board precedent. The decision in Mt. Clemens does address a prohibition on the wearing of a union
insignia in patient care areas, but, once again, in a context where the prohibition was also applied in non-
patient-care areas. If a rule prohibits the wearing of union insignia in both patient-care and non-patient-
care areas that rule is presumptively invalid, and special treatment is not carved out for its application in
patient-care areas. See, e.g., London Memorial Hospital, 238 NLRB at 704 fn.2 (“We find it unnecessary
to decide whether . . . a rule prohibiting the employees from wearing union buttons on [the employer’s]
second floor would be ‘justified presumptively’ because of the nature and severity of the mental
disturbances to be found among the patients on that floor, inasmuch as the rule in question was neither
promulgated nor enforced in such a limited manner.”); see also The Times Publishing Company, 231
NLRB 207, 208 (1977) (When an employer promulgates and maintains an overly broad restriction “those
rules are invalid for all purposes and not valid in part as they apply to a given area.”). Nevertheless, in
Mt. Clemens the Board affirmed the administrative law judge’s decision, which referenced the rule that an
employer’s restriction on union paraphernalia is presumptively valid in patient-care areas and went on to
find that the prohibition at-issue in that case violated Section 8(a)(1). The administrative law judge gave
multiple reasons for this decision, including that: the Respondent did not prohibit the wearing of any other
insignia or union buttons in all areas of the hospital including patient care areas; the Respondent did not
put in writing any reasons for its belief that wearing of the button could cause disruptions; there were no
evidence that patients or their families complained about the button or felt that it interfered with patient
care or safety; there was no evidence that the button caused disruption in the workplace; the employer had
permitted the wearing of other buttons that the Respondent conceded “could be construed as controversial
not unlike the [button that had been prohibited]”; and the at-issue button did not cause a work stoppage or
sit-down strike.
JD–50–11
12
controversial and inflammatory.13 It uses an image of imminent violence and bodily harm, and 5
anxiety over personal physical safety. Display of such an image in patient-care areas would
reasonably be expected to interfere with the maintenance of the "restful, uncluttered, relaxing,
and helpful atmosphere" that the Supreme Court has recognized patients require. It is hard to
imagine that seeing the stomp sticker on their caretakers would not disturb the hospital’s
patients, especially some of those in the emergency department who are in acute medical or 10
psychological distress. See Northwoods Rehabilitation and Extended Care Facility, 344 NLRB
1040, 1052 (2005) (The condition of the patients who will be exposed to a union button is one
factor to be considered when determining whether a hospital may impose a restriction on such
activity.).
15
The Union suggests that the restrictions the Respondent applied starting in December
2010 were motivated by discrimination based on the contemporaneous negotiations for a new
collective bargaining agreement. That is not borne out by the record. The contract negotiations
began in August 2010 – approximately 4 months before the Respondent took any of the actions
alleged to be unlawful in this case.14 Throughout the negotiations, the Respondent has permitted 20
employees in both patient and non-patient areas to wear a variety of accessories expressing the
employees' affiliation with the Union. Neither the Union nor the General Counsel introduced
evidence showing that in December 2010 contract negotiations changed in some significant
respect that would be expected to lead the Respondent to begin discriminating at that time.
Moreover, the record does not show that, prior to December 22, 2010, employees working in 25
patient-care areas had worn any type of button or sticker (either union-related or not) that was as
controversial or inflammatory as the stomp sticker. The record evidence fails to show that the
Respondent’s decision to prohibit the stomp sticker in patient-care areas, but not to restrict other
union and non-union accessories, was based on something other than the significantly more
controversial, inflammatory, and disturbing nature of the stomp sticker. Cf. Nordstrom, Inc. 264 30
NLRB 698, 700 (1982) (ban on union button unlawful where, inter alia, the button was small and
did not contain provocative language).
In finding for the Respondent on this issue, I considered the lack of reliable evidence that
any patient or visitor made a complaint about the sticker, had a discussion with an employee 35
about the sticker, or was actually disturbed by the sticker.15 Restrictions on union activity in a

13 I recognize that the Respondent’s unwritten restriction on “controversial and inflammatory”
accessories is worded broadly, however, the stomp sticker clearly falls within almost any reasonable
understanding of what those terms would mean in the setting of a hospital’s patient-care areas.
14 Timing is an important factor in assessing discriminatory motivation. See, e.g. LB&B Associates,
Inc., 346 NLRB 1025, 1026 (2005), enfd. 232 Fed. Appx. 270 (4th Cir. 2007); Desert Toyota, 346 NLRB
118, 120 (2005); Detroit Paneling Systems, 330 NLRB 1170 (2000), enfd. sub nom. Carolina Holdings,
Inc. v. NLRB, 5 Fed. Appx. 236 (4th Cir. 2001); Bethlehem Temple Learning Center, 330 NLRB 1177,
1178 (2000); American Wire Products, 313 NLRB 989, 994 (1994).
15 The Respondent argues that there was evidence of disruption inasmuch as, after Macagnone was
called into Naccarato’s office about the stomp sticker, nurses discussed the possibility of being
disciplined for wearing it, and because Union officials who came to the facility to contest the discipline
against Macagnone caused a commotion in a hallway near a patient care area. I do not consider either
purported disruption in ruling on the lawfulness of the Respondent’s prohibition of the sticker because
both were reactions to the Respondent’s prohibition of the sticker, not to the sticker itself. An employer
cannot rely on disruptions caused by its own unlawful reaction to otherwise protected union activity to
JD–50–11
13
hospital's patient-care areas can, however, lawfully be based on reasonable concern that such 5
activity "may have adverse effects on [patients’] recovery" even absent evidence that the feared
effects have actually occurred. NLRB v. Baptist Hospital, 442 U.S. at 784 (emphasis added).
Thus, in Northwoods Rehabilitation and Extended Care Facility, the hospital could rely on the
"potential adverse effect" of a union button on patients to defend its restriction on the display of
the button. 344 NLRB at 1052. Similarly, in Pathmark Stores it was held that the employer had 10
a legitimate interest in restricting the wearing of a controversial union button based on the
button’s "reasonably likely effect on customers" even though there was no evidence that the
effect had occurred. 342 NLRB 378, 379 (2004). Given the nature of the image on the stomp
sticker, I conclude that concerns about its adverse effects on patients were legitimate.
15
I also considered the decision in Mt. Clemens General Hospital, 335 NLRB at 50, which
is cited by the General Counsel and the Union. In that case the Board affirmed the
administrative law judge's conclusion that the employer's restriction on employees' display of a
union button in both non-patient-care and patient-care areas was a violation of Section 8(a)(1).
In reaching that conclusion the judge relied, inter alia, on the fact that employees in the hospital, 20
including in patient-care areas, were permitted to wear other sorts of buttons and on the lack of
the evidence that the disputed union button was disturbing patients. The facts in Mt. Clemens are
unlike those at-issue here in a number of the most relevant respects. First, the restriction in Mt.
Clemens applied in both patient-care and non-patient-care areas. Although the judge referenced
the presumption of validity that attaches to restrictions that apply exclusively in patient-care 25
areas, the applicable presumption under the circumstances present there was against the validity
of the restriction since the restriction applied beyond patient-care areas. London Memorial
Hospital, 238 NLRB at 704 fn. 2; see also The Times Publishing Company, 231 NLRB at 208
(an overly broad restriction is “invalid for all purposes and not valid in part as they apply to a
given area”). Second, in Mt. Clemens, unlike the instant case, the Respondent actually 30
confiscated the buttons that the union distributed rather than simply telling employees to remove
them. This meant that the employees in Mt. Clemens, unlike those here, could not simply re-
attach the buttons upon exiting patient-care areas. Third, in Mt. Clemens the hospital conceded
that it had previously permitted the wearing of other buttons that were as controversial as the
union button that it was prohibiting. In the instant case, the Respondent does not concede, and 35
the record does not show, that buttons or stickers as controversial as the stomp sticker had
previously been permitted in patient-care areas of the hospital. Finally, the button at issue in Mt.
Clemens was manifestly less controversial and less likely to disturb patients than is the stomp
sticker. The button in Mt. Clemens simply showed the letters FOT with a line through them to
express the employees' opposition to forced overtime. That button, unlike the stomp sticker, did40
not use an image of violence, bodily harm, and anxiety over personal safety to convey its
message. For these reasons, I find that the Mt. Clemens decision is not controlling here.
I conclude that the evidence does not show that the Respondent violated Section 8(a)(1)
on December 23 by threatening employees with discipline for wearing the stomp sticker or by 45
promulgating and maintaining a rule prohibiting employees from wearing the stomp sticker in
patient-care areas. The complaint allegations related to these actions should be dismissed.

strip that union activity of its protected status.
JD–50–11
14
5
"Proud 1199 SEIU Member" Button: I conclude that the General Counsel has met its
burden of showing that the Respondent acted without a reasonable basis when, on January 18,
2011, Naccarato directed Macagnone to remove the "proud 1199" button. This button is
essentially a statement of affiliation, something that the Respondent states that its professional
image policy allows employees to display in patient-care areas. Indeed, the evidence shows that 10
the Respondent has permitted employees in patient-care areas to wear accessories showing their
affiliation with numerous entities, including educational institutions, certification programs, the
Knights of Columbus, and a volunteer firefighter group, as well as in some instances the Union.
The "proud 1199" button does not include any statements that explicitly or implicitly reference a
conflict between the Respondent and employees. It does not mention any problems at the 15
hospital, or advocate for any changes there. This statement of the employee's affiliation with the
Union, and personal pride in that affiliation, is not facially controversial or inflammatory.
Naccarato testified that the button was more than a mere statement of affiliation because
of its size which she characterized as "a little exorbitant." The size of the "proud 1199" button –20
standing alone as it is here – is not a legitimate basis on which to prohibit it. Although the size
of a union button is one factor that is often considered in determining whether an employer may
prohibit that button, precedent indicates that more than size on the order of the proud 1199
button is required to create a legitimate basis for a prohibition. In Asociacion Hospital Del
Maestro, a hospital’s restrictions on a union button that was 2 ½ inches in diameter and a union 25
ribbon that was 4 inches long were held to be unlawful despite the large size of those accessories
because, inter alia, hospital employees were permitted to wear various other types of buttons and
ribbons. 283 NLRB 419, 421 and 427 fn. 9 (1987), enfd. 842 F.2d 575 (1st Cir. 1988). In Mesa
Vista Hospital, a hospital's restriction of 2 by 3 inch union badges was held to be unlawful
because, inter alia, the hospital employees involved were not required to wear white nurses'30
uniforms. 280 NLRB 298, 300 fn.14 and 302 (1986). In the instant case, the button was 3
inches wide, but as in Hospital Del Maestro and Mesa Vista, employees were permitted to wear a
variety of other buttons and accessories and Macagnone was not required to wear a white nurse’s
uniform. I conclude that, in the instant case, the size of the "proud 1199" button, standing alone,
was not a legitimate basis for banning that button. Therefore, the General Counsel has met its 35
responsive burden.
In reaching this conclusion, I do not make any finding as to whether anti-union animus
motivated the Respondent to restrict the proud 1199 button. I nevertheless conclude that, by
prohibiting the button, the Respondent failed to strike the legally required balance between 40
Macagnone's Section 7 rights and the "interest and comfort of patients" at the hospital. Medical
Center of Beaver County, 266 NLRB at 430; see also NLRB v. Baptist Hosp., 442 U.S. at 779.
For the reasons discussed above, I find that the Respondent violated Section 8(a)(1) on
January 18, 2011, when Naccarato directed Macagnone to cease displaying the proud 1199 45
button in a patient-care area.
"Access Denied" Button: As discussed above, I find that the restriction on Coates’
display of the “access denied” button applied only in a patient-care area (the intensive care unit)
and that, as a result, the restriction is presumptively lawful. Sacred Heart Medical Center supra. 50
The General Counsel may rebut that presumption by showing that the prohibition was enforced
JD–50–11
15
discriminatorily or without a legitimate basis. I find that the General Counsel has failed to make 5
that showing.
The button at-issue is not in the category of "mere statements of affiliation" that the
Respondent's policy permits. The button’s message – "ACCESS DENIED! Ask the Boss
WHY?” – attempts to place the reader in the middle of a dispute between the caretaking 10
employee and the management of the hospital. The button is large, approximately 3 inches in
diameter, and likely to be noticed by patients. Moreover, I believe that Altomer was reasonably
concerned that the button's ambiguous message would be understood by some patients as
suggesting that the hospital was denying care or services to them. That is a disturbing message
for patients who are relying on the hospital’s care. Exposure to the message is likely to interfere 15
with the "restful, uncluttered, relaxing, and helpful atmosphere" that the Supreme Court has said
that hospital patients require. See NLRB v. Baptist Hospital, Inc., supra. I note moreover, that as
with the other union paraphernalia, the Respondent did not confiscate the access denied button or
otherwise attempt to prevent anyone from wearing it in areas that were not dedicated to patient
care. I conclude that enforcement of the prohibition in this instance had a legitimate basis – the 20
controversial, inflammatory, and potentially disturbing nature of the button’s message and the
Respondent’s need to maintain an atmosphere conducive to patient care.
I recognize that for some months prior to December 24 Coates had been permitted to
wear the access denied button. However, I find that, under the circumstances here, this does not 25
show that the Respondent was enforcing its rule in manner that was discriminatory or without a
legitimate basis. I note first that the difference here is in the way the Respondent treated the
same button being worn by the same employee. It is difficult to see how such a difference could
be the result of discrimination on the basis of the union content of the button or Coates’ protected
activities. The General Counsel did not show that the Respondent permitted other employees in 30
patient-care areas to display buttons that were similarly controversial and/or inflammatory, but
which did not concern the Union, or that Coates was a more active union supporter than any
other employees who may have been permitted to wear the same button in patient-care areas. In
addition, as discussed above, the evidence did not show that, in December 2010, anything
changed regarding the bargaining between the parties that would explain a change in the 35
Respondent’s stance with respect to the access denied button. Rather, in this instance the most
likely explanation for the difference in the way the Respondent reacted to Coates’ display of the
button on December 24 is that different supervisors were involved. Altomer did not generally
have authority over the intensive care unit where Coates worked, but on the day in question she
was substituting in a position that required her to supervise that unit. Prior to seeing Coates 40
wearing the access denied button on December 24, Altomer had never seen any employee in a
patient-care area wearing the button. The fact that different supervisors had different views of
the same button does not show that the difference in treatment was discriminatory. As the Board
has recognized, "the arguably uneven” application of the same policy by different supervisors
"cannot reasonably be relied on alone to supply an 'inference'" of discrimination. Otani Hotel & 45
Garden, 325 NLRB 928, 941 (1998).
I conclude that the evidence does not show that the Respondent violated Section 8(a)(1)
on December 24, 2010, by threatening an employee with discipline for wearing the “access
denied” button. The complaint allegations relating to this should be dismissed.50
JD–50–11
16
"Have a Heart" Sticker: I conclude that the General Counsel has met its burden with 5
respect to the Respondent’s decision to prohibit Coates from wearing a sticker that reads "HAVE
A HEART DO YOUR PART" in large lettering and identifies the Union in small lettering. This
sticker communicates a facially benign, even warm, sentiment. The message is not one that a
reasonable patient would interpret as controversial, inflammatory or disturbing. Contrary to the
Respondent's assertion, the message in no way suggests that the hospital is being heartless and 10
inhumane. I note, moreover, that Coates was not required to wear a white nurse’s uniform at
work and that the hospital allowed employees to wear a wide range of other non-controversial
and non-inflammatory buttons and stickers. See Asociacion Hospital Del Maestro, supra, and
Mesa Vista Hospital, supra. At trial, the Respondent failed to call a single hospital official who
was involved in the decision to restrict the heart sticker to testify about the basis for that decision 15
or even to state that they believed display of the sticker violated hospital policy. On balance, I
find that the record evidence shows that the Respondent's decision to prohibit Coates from
displaying the "have a heart" sticker while permitting employees to wear buttons communicating
other types of non-controversial/non-inflammatory sentiments, was without a legitimate basis.
Therefore, the General Counsel has satisfied its responsive burden.20
For the reasons discussed above, I conclude that the Respondent violated Section 8(a)(1)
on February, 14 2011, when Freiss directed Coates to cease displaying the heart sticker in a
patient-care area.
25
B. Section 8(a)(3) Allegation
The General Counsel contends that the Respondent violated Section 8(a)(3) and (1)
when, on December 23, 2010, Naccarato suspended Macagnone for wearing the stomp sticker.
The only basis that the General Counsel asserts for finding that the suspension was unlawful is 30
that, under Board precedent, discipline imposed pursuant to an unlawful rule is itself a violation
of Section 8(a)(3) and (1). Brief of General Counsel at Pages 14 and 16, citing London
Memorial Hospital, 238 NLRB at 709, and A.T. & S.F. Memorial Hospitals, Inc., 234 NLRB 436
(1978); see also Continental Group, Inc., 357 NLRB No. 39, slip op. at 4 (2011) ("[D]iscipline
imposed pursuant to an unlawfully overbroad rule violates the Act in those situations in which an 35
employee violated the rule by (1) engaging in protected conduct or (2) engaging in conduct that
otherwise implicates the concerns underlying Section 7 of the Act."). For the reasons discussed
above, the Respondent's prohibition on the display of the stomp sticker in patient-care areas was
not unlawful. Therefore, the General Counsel's contention that Macagnone's suspension was
unlawful because it occurred pursuant to an unlawful rule necessarily fails.40
In its brief the Union forwards another theory, arguing that Macagnone's suspension was
in retaliation for his union activism – including his distribution of the stomp sticker to others, his
status as a "delegate in training," and his presence at contract negotiations. This retaliation
theory was not alleged or litigated by the General Counsel. Even if the theory had merit, I would 45
not find a violation based upon it because the General Counsel controls the complaint, and the
Charging Party Union cannot enlarge upon or change the General Counsel's theory of the case.
Dana Corp., 356 NLRB No. 49, slip op. at 3-4 fn.6 (2010). At any rate, the Union’s retaliation
theory lack merits. First of all, the record does not show that the Respondent knew that
Macagnone had engaged in any union activity beyond his display of the stomp sticker and his 50
attendance at a number of negotiating sessions. Nor does the record show that any employees
JD–50–11
17
who might arguably have been treated better than Macagnone did any less to support the Union 5
than he did. More importantly, the record shows that Macagnone was treated no differently than
other employees who wore the same union sticker. On December 23, Naccarato saw three
employees in the emergency department wearing the stomp sticker – Macagnone, Propst and
Roule. She told each of the three to remove the sticker. Propst and Roule complied and were
not disciplined. Macagnone repeatedly refused, even after being advised that refusal would 10
result in suspension, and he was suspended. On this record, there is no reason to believe that
Propst and Roule were treated differently than Macagnone for any reason other than the fact that
they complied with the Respondent’s lawful instruction regarding the stomp sticker, while
Macagnone did not. The view that Macagnone was suspended because he refused his
employer’s lawful instruction to remove the stomp sticker, not because of his other union 15
activity, is further supported by the fact that subsequently, on January 18, when Macagnone
complied with his employer’s instruction to remove the “proud 1199” button he was not
disciplined in any way. Thus Macagnone was treated in the same way that Propst and Roule as
well as Coates were treated. None of them were disciplined when they complied with the
Respondent’s instructions to remove union paraphernalia. 20
I conclude that the evidence does not show that the Respondent violated Section 8(a)(3)
and (1) on December 23 when it suspended Macagnone. The complaint allegations relating to
the suspension should be dismissed.
25
CONCLUSIONS OF LAW
1. The Respondent, Columbia Memorial Hospital, is an employer engaged in commerce
within the meaning of Section 2(2), (6) and (7) of the Act, and a health care institution within
the meaning of Section 2(14) of the Act.30
2. The Union, 1199 SEIU, United Healthcare Workers East, is a labor organization
within the meaning of Section 2(5) of the Act.
3. The Respondent violated Section 8(a)(1): on January 18, 2011, when Naccarato 35
directed Macagnone to cease displaying the “proud 1199” button in a patient-care area; and on
February 14, 2011, when Freiss directed Coates to cease displaying the “have a heart” sticker in
a patient-care area.
4. The Respondent was not shown to have committed the other violations alleged in the 40
complaint.
REMEDY
Having found that the Respondent has engaged in certain unfair labor practices, I shall 45
order it to cease and desist there from and to take certain affirmative action designed to
effectuate the policies of the Act. In particular, the Respondent must rescind any rule or practice
prohibiting employees from wearing the “proud 1199” button or the “have a heart” sticker that
were at-issue in this proceeding.
50
JD–50–11
18
On these findings of fact and conclusions of law and on the entire record, I issue the 5
following recommended Order.16
ORDER
The Respondent, Columbia Memorial Hospital, Hudson, New York, its officers, agents, 10
successors, and assigns, shall
1. Cease and desist from
(a) Prohibiting employees from displaying the union button that reads "PROUD 1199 15
SEIU Member," see Appendix C, or the union sticker that reads “HAVE A HEART DO YOUR
PART,” see Appendix E.
(b) Threatening employees with discipline for displaying either the union button or the
union sticker referenced in the preceding paragraph.20
(c) Enforcing any restriction on employees' display of union paraphernalia in patient-care
areas in a manner that is discriminatory or without a legitimate basis.
(d) In any like or related manner interfering with, restraining, or coercing employees in 25
the exercise of the rights guaranteed them by Section 7 of the Act.
2. Take the following affirmative action necessary to effectuate the policies of the Act.
(a) Rescind any rule or practice restricting employees’ display of the union paraphernalia 30
referenced in paragraph 1(a) of this Order.
(b) Within 14 days after service by the Region, post at its facility in Hudson, New York,
copies of the attached notice marked "Appendix A."17 Copies of the notice, on forms provided by
the Regional Director for Region Three, after being signed by the Respondent’s authorized 35
representative, shall be posted by the Respondent and maintained for 60 consecutive days in
conspicuous places including all places where notices to employees are customarily posted. In
addition to physical posting of paper notices, the notices shall be distributed electronically, such
as by email, posting on an intranet or an internet site, and/or other electronic means, if the
Respondent customarily communicates with its employees by such means. Reasonable steps 40
shall be taken by the Respondent to ensure that the notices are not altered, defaced, or covered by
any other material. In the event that, during the pendency of these proceedings, the Respondent
has gone out of business or closed the facility involved in these proceedings, the Respondent

16 If no exceptions are filed as provided by Sec. 102.46 of the Board’s Rules and Regulations, the
findings, conclusions, and recommended Order shall, as provided in Sec. 102.48 of the Rules, be adopted
by the Board and all objections to them shall be deemed waived for all purposes.
17 If this Order is enforced by a judgment of a United States court of appeals, the words in the notice
reading “Posted by Order of the National Labor Relations Board” shall read “Posted Pursuant to a
Judgment of the United States Court of Appeals Enforcing an Order of the National Labor Relations
Board.”
JD–50–11
19
shall duplicate and mail, at its own expense, a copy of the notice to all current employees and 5
former employees employed by the Respondent at any time since January 18, 2011.
(c) Within 21 days after service by the Region, file with the Regional Director a sworn
certification of a responsible official on a form provided by the Region attesting to the steps that
the Respondent has taken to comply.10
IT IS FURTHER ORDERED that the complaint is dismissed insofar as it alleges
violations of the Act not specifically found.
15
Dated, Washington, D.C. August 26, 2011
____________________20
Paul Bogas
Administrative Law Judge
20
APPENDIX A
NOTICE TO EMPLOYEES
Posted by Order of the
National Labor Relations Board
An Agency of the United States Government
The National Labor Relations Board has found that we violated Federal labor law and has
ordered us to post and obey this notice.
FEDERAL LAW GIVES YOU THE RIGHT TO
Form, join, or assist a union
Choose representatives to bargain with us on your behalf
Act together with other employees for your benefit and protection
Choose not to engage in any of these protected activities.
WE WILL NOT prohibit you from wearing the union button that reads “PROUD 1199 SEIU
Member,” or the union sticker that reads “HAVE A HEART DO YOUR PART.”
WE WILL NOT threaten you with discipline for displaying either the union button or the union
sticker referenced above.
WE WILL NOT enforce any restriction on your display of union paraphernalia in patient-care
areas in a manner that is discriminatory or without a legitimate basis.
WE WILL NOT in any like or related manner interfere with, restrain, or coerce you in the
exercise of the rights guaranteed you by Section 7 of the Act.
WE WILL rescind any rule or practice restricting your right to display the union button that
reads “PROUD 1199 SEIU Member,” and/or the union sticker that reads “HAVE A HEART DO
YOUR PART.”
Columbia Memorial Hospital
(Employer)
Dated By
(Representative) (Title)
21
22
23
24